Abstract
Low back pain occurs in almost 80% of adults at some point in their lives.1 It is estimated that 1400 workdays per 1000 workers are lost each year in the United States because of low back pain.2 In many large industrial settings, low back pain is second only to upper respiratory infections as a cause for absence from work.3 Among chronic conditions, back problems are the most frequent cause for limitation of activity (work, housekeeping, school) among patients under 45 years of age.4 Although low back pain is usually a self-limited problem, it still costs approximately $51 billion per year in lost productivity and compensation.5 Fortunately, low back pain can be treated simply with a conservative regimen coupled with timely surgical intervention for a few patients plus aggressive rehabilitation for patients with chronic low back pain.6
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Deyo RA, Loeser JD, Vigos SJ. Herniated lumbar inter-vertebral disc. Ann Intern Med 1990;112:598–603.
Jackson CP, Brown MD. Is there a role for exercise in treatment of patients with low back pain? Clin Orthop 1983;179:39–45.
Spitzer WO, LeBlanc FE, Dupuis M, et al. Scientific approach to the assessment and management of activity related spinal disorders: a monograph for clinicians; report of the Quebec Task Force on Spinal Disorders. Spine 1987;12 Suppl l:Sl-59.
Deyo RA. Conservative therapy for low back pain. JAMA 1983;250:1057–62.
Frymoyer JW, Cats-Baril WL. An overview of the incidences and costs of low back pain. Orthop Clin North Am 1991;22:263–71.
Frymoyer JW. Back pain and sciatica. N Engl J Med 1988;318:291–300.
Frymoyer JW, Pope MH, Clements JH, Wilder DG, MacPherson B, Ashikaga T. Risk factors in low back pain: an epidemiological survey. J Bone Joint Surg [Am] 1983;65:213–8.
Nachemson A. Work for all: for those with low back pain as well. Clin Orthop 1983;179:77–85.
Waddell G. A new clinical model for the treatment of low back pain. Spine 1987;12:632–44.
White AA III, Gordon SL. Synopsis: workshop on idiopathic low back pain. Spine 1982;7:141–9.
Deyo RA, Tsui-Wu YJ. Descriptive epidemiology of low back pain and its related medical care in the United States. Spine 1987; 12: 264–8.
Hazard RG, Fenwick JW, Kaiisch SM, et al. Functional restoration with behavioral support: a one-year prospective study of patients with chronic low back pain. Spine 1989;14:157–69.
Weber H. Lumbar disc herniation: a controlled prospective study with ten years of observation. Spine 1983;8:131–40.
Kelsey JL. Epidemiology of radiculopathies. Adv Neurol 1978; 19: 385–9.
Kelsey JL, Githens PB, O’Conner T, et al. Acute prolapsed lumbar inter-vertebral disc: an epidemiologic study with special reference to driving automobiles and cigarette smoking. Spine 1984;9:608–11.
Kelsey JL, Githens PD, White AA, et al. An epidemiologic study of lifting and twisting on the job and risk for acute prolapsed lumbar inter-vertebral disc. J Orthop Res 1984;2:61–9.
Spangfort EV. The lumbar disc herniation: a computer-aided analysis of 2,504 operations. Acta Orthop Scand Suppl 1972;142:5–95.
National Center for Health Statistics. Prevalence of selected impairments, U.S., 1977, Series 10, No. 132. DHHS Publ. (PHS) 81–1562. Hyattsville, MD: NCHS, 1981.
Holbrook TL, Grazier KL, Kelsey JL, Stauffer RN. The frequency of occurrence, impact, and cost of musculoskeletal conditions in the United States. Chicago: American Academy of Orthopaedic Surgeons; 1984:154–7.
Frymoyer JW, Nachemson A. Natural history of low back disorders. In: Frymoyer JW, editor. The adult spine: principles and practice. New York: Raven Press, 1991:1537–50.
Waddell G. A new clinical model for the treatment of low back pain. In: Weinstein JN, Wiesel SW, editors. The lumbar spine. Philadelphia: Saunders, 1990:1537–50.
Nachemson A. Newest knowledge of low back pain: a critical look. Clin Orthop 1992;279:8–20.
Cassidy JD, Wedge JH. The epidemiology and natural history of low back pain and spinal degeneration. In: Kirkaldy-Willis WH, editor. Managing low back pain. 2nd ed. New York: Churchill Livingstone, 1988:3–14.
Deyo RA, Bass JE. Lifestyles and low back pain: the influence of smoking and obesity. Spine 1989;14:501–6.
Fairbank JCT, Hall H. History taking and physical examination: identification of syndromes of back pain. In: Weinstein JN, Wiesel SW, editors. The lumbar spine. Philadelphia: Saunders, 1990:88–106.
Melzack R. The McGill Pain Questionnaire: major properties and scoring mechanisms. Pain 1975;1:277–99.
Modic MT, Ross JS. Magnetic resonance imaging in the evaluation of low back pain. Orthop Clin North Am 1991;22:283–301.
Deyo RA, Diehl AK. Lumbar spine films in primary care: current use and effects of selective ordering criteria. J Gen Intern Med 1986;1:20–25.
Hensinger RN. Spondylolysis and spondylolisthesis in children and adolescents. J Bone Joint Surg [Am] 1989;71:1098–107.
Frymoyer JW, Newberg A, Pope MH, Wilder DG, Clements J, MacPherson B. Spine radiographs in patients with low back pain: an epidemiological study in men. J Bone Joint Surg [Am] 1984; 66:1048–55.
Ross JS, Masaryk TJ, Modic MT. Lumbar spine. In: Stark DD, Bradley WG Jr, editors. Magnetic resonance imaging. 2nd ed. St. Louis: Mosby, 1992:1339–69.
Modic MT, Masaryk T, Boumphrey F, Goormastic M, Bell G. Lumbar herniated disc disease and canal stenosis: prospective evaluation by surface coil MR, CT, and myelography. AJR 1986; 147:757–65.
Mixter WJ, Barr JS. Rupture of inter-vertebral disc with involvement of the spinal canal. N Engl J Med 1934;211:210–15.
Jackson RP. The facet syndrome: myth or reality? Spine 1992; 279:110–21.
Carette S, Marcoux S, Truchon R, et al. A controlled trial of corticosteroid injections into facet joints for chronic low back pain. N Engl J Med 1991;325:1002–7.
Lilius G, Laasonen EM, Myllynen P, Harilainen A, Gronlund G. Lumbar facet joint syndrome: a randomized clinical trial. J Bone Joint Surg [Br] 1989;71:681–4.
Camins MB, O’Leary PF, editors. The lumbar spine. New York: Raven Press, 1987.
Deyo RA, Diehl AK. Cancer as a cause of back pain: frequency, clinical presentation, and diagnostic strategies. J Gen Intern Med 1988;3:230–8.
Bates DW, Reuler JB. Back pain and epidural spinal cord compression. J Gen Intern Med 1988;3:191–7.
Perrin RG. Symptomatic spinal metastases. Am Fam Physician 1989;39:165–72.
McCowin PR, Borenstein D, Wiesel SW. The current approach to the medical diagnosis of low back pain. Orthop Clin North Am 1991;22:315–25.
Barth RW, Lane JM. Osteoporosis. Orthop Clin North Am 1988;19:845–58.
Frymoyer JW, Rosen JC, Clements J, Pope MH. Psychologic factors in low back pain disability. Clin Orthop 1985;195:178–84.
Hurme M, Alaranta H. Factors predicting the results of surgery for lumbar inter-vertebral disc herniation. Spine 1987;12:933–8.
Deyo RA, Diehl AK, Rosenthal M. How many days of bedrest for acute low back pain? A randomized clinical trial. N Engl J Med 1986;315:1064–70.
Berry H, Bloom B, Hamilton EBD, et al. Naproxen sodium, dif-lunisal and placebo in the treatment of chronic back pain. Ann Rheum Dis 1982;41:122–32.
Deyo RA, Walsh NE, Martin DC, Schoenfeld LS, Ramamurthy S. A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. N Engl J Med 1990;322:1627–34.
Kendall PH, Jenkins JM. Exercises for backache: a double blind controlled trial. Physiotherapy 1968;54:154–9.
Williams PC. Lesions of lumbo-sacral spine. Part 2. J Bone Joint Surg 1937;19:690–703.
McKenzie RA. Prophylaxis in recurrent low back pain. N Z Med J 1979;89:22–3.
Elnaggar IM, Nordin M, Sheikhzadeh A, Parnianpour M, Kahanovitz N. Effects of spinal flexion and extension exercises on low back pain and spinal mobility in chronic mechanical low-back pain patients. Spine 1991;16:967–72.
Jackson CP, Brown MD. Analysis of current approaches a practical guide to prescription of exercise. Clin Orthop 1983;179:46–54.
Cady LD, Bischoff DP. Strength and fitness and subsequent back injuries in firefighters. J Occup Med 1979;21:269–73.
Berquist-Ullman M, Larsson U. Acute low back pain in industry: a controlled prospective study with special reference to therapy and confounding factors. Acta Orthop Scand Suppl 1977;170:1–117.
Hall H, Iceton JA. Back school: an overview with specific reference to the Canadian back education units. Clin Orthop 1983; 179: 10–17.
Stankovic R, Johnell O. Conservative treatment of acute low back pain. Spine 1990;15:120–3.
Klaber-Moffett JA, Chase SM, Portek I, Ennis JR. A controlled prospective study to evaluate the effectiveness of a back school in the relief of chronic low back pain. Spine 1986;11:120–2.
Abramovitz JN, Neff SR. Lumbar disc surgery: results of the prospective lumbar discectomy study. Neurosurgery 1991;29: 301–8.
Kambin P, Schaffer JL. Percutaneous lumbar discectomy: review of 100 patients in current practice. Clin Orthop 1989;238: 24–34.
Muralikuttan KP, Hamilton A, Kernohan WS, Mollan RAB, Adair IV. A prospective randomized trial of chemonucleolysis and conventional disc surgery. Spine 1992;17:381–7.
Herkowitz HN. Current status of percutaneous discectomy and chemonucleolysis. Orthop Clin North Am 1991;22:327–32.
Huit L. The Munkfors investigation. Acta Orthop Scand Suppl 1959;16:1–16.
Kelsey JL, Githens PB, Walter SD, et al. An epidemiological study of acute prolapsed cervical intervertebral disc. J Bone Joint Surg [Am] 1984;66:907–14.
Dillin W, Booth R, Cuckler J, Balderston R, Simeone F, Rothman R. Cervical radiculopathy: a review. Spine 1986;11:988–91.
Lestini WF, Wiesel SW. The pathogenesis of cervical spondylosis. Clin Orthop 1989;239:69–93.
Clark CR. Degenerative conditions of the spine. In: Frymoyer JW, editor. The adult spine: principles and practice. New York: Raven Press, 1991:1145–64.
Murphy MJ, Lieponis JV. Non-operative treatment of cervical spine pain. In: Sherk HH, editor. The cervical spine. Philadelphia: Lippincott, 1989:670–7.
Jahnke RW, Hart BL. Cervical stenosis, spondylosis, and herniated disc disease. Radiol Clin North Am 1991;29:777–91.
Russell EJ. Cervical disk disease. Radiology 1990;177:313–25.
La Rocca H. Cervical spondylotic myelopathy: natural history. Spine 1988;13:854–5.
White AA III, Panjabi MM. Biomechanical considerations in the surgical management of cervical spondylotic myelopathy. Spine 1988;13:856–69.
Hirsch SA, Hirsch PJ, Hiramoto H, Weiss A. Whiplash syndrome: fact or fiction? Orthop Clin North Am 1988;19:791–5.
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Calmbach, W.L. (1994). Disorders of the Back and Neck. In: Taylor, R.B. (eds) Family Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-4005-9_110
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DOI: https://doi.org/10.1007/978-1-4757-4005-9_110
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